Headache, earache, ear fullness, and abnormalities of the ear pressure equalization tube "Eustachian tube"

Phyathai 3

4 Min

29/04/2021

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Headache, earache, ear fullness, and abnormalities of the ear pressure equalization tube "Eustachian tube"

When experiencing symptoms of dizziness with spinning sensation, ear fullness, ringing in the ears, ear pain or even headache, the cause should be identified because these symptoms may result from abnormalities in the middle ear and the nasopharynx, where the pressure-regulating tube of the ear, or “Eustachian tube”, is located. Leaving it untreated may cause the condition to worsen and become more difficult to treat. Therefore, when these symptoms occur, it is advisable to promptly consult a specialist for diagnosis and further treatment.

 

Treatment for Eustachian tube dysfunction using Balloon Dilation of the Eustachian tube

 

What is the Eustachian tube?

The Eustachian tube is the pressure-regulating tube of the ear, connecting the middle ear to the nasopharynx. The main functions of the Eustachian tube are:

  • To regulate the pressure in the middle ear
  • To ventilate and circulate air in the middle ear
  • To drain fluid from the middle ear into the back of the nasopharynx

If this tube malfunctions, it can cause symptoms such as ear fullness, ear pain, headache, ringing in the ears, or in severe cases, dizziness with a spinning sensation.

 

Causes of Eustachian tube dysfunction

Eustachian tube dysfunction can result from diseases, environmental factors, and normal lifestyle activities, such as:

  1. Inflammation and swelling of the nose, sinuses, or nasopharynx, inflammation of the adenoids, radiation therapy in the nasopharynx area, which causes the mucous membrane around the Eustachian tube to swell or narrow, leading to dysfunction.
  2. Rapid or sudden changes in atmospheric pressure, such as quickly ascending or descending in an elevator, rapid takeoff or landing of an airplane, or diving with rapid depth changes.
  3. Blockage of the Eustachian tube opening by a mass, causing dysfunction and negative pressure in the middle ear, such as enlarged adenoids blocking the Eustachian tube opening, or nasopharyngeal cancer spreading to the Eustachian tube, causing dysfunction.

 

Possible findings when the Eustachian tube malfunctions

When a patient visits a doctor with symptoms suspected to be related to Eustachian tube dysfunction, the doctor will examine for abnormalities, which may include:

  1. Opaque eardrum, possibly with fluid inside the middle ear
  2. Retracted eardrum due to negative pressure in the middle ear; in severe cases, the eardrum may retract enough to perforate
  3. Some patients may have bleeding on the eardrum, with parts of the eardrum swollen and red due to increased blood congestion
  4. Hearing loss varying with the severity of the condition; some may hear clicking sounds in the ear, especially when swallowing

 

Treatment and self-care for Eustachian tube dysfunction

  1. Use of medication to relieve nasal inflammation, such as antihistamines, oral decongestants (e.g., pseudoephedrine), or nasal decongestant sprays (e.g., ephedrine, oxymetazoline), possibly combined with nasal irrigation and nasal steroid sprays to reduce inflammation inside the nose. This reduces blood flow to the Eustachian tube, causing the mucous membrane around the tube opening to shrink, allowing fluid accumulated in the middle ear to drain better through the Eustachian tube.
  2. Chewing gum to help open the Eustachian tube
  3. Performing the Valsalva maneuver by taking a deep breath, closing the nose and mouth, then gently blowing air through the closed nose to force air through the Eustachian tube into the middle ear. This should not be done during a cold or sinus infection as it may push pathogens from the nose or sinuses into the middle ear.
  4. Surgery, if medication treatment is ineffective, which can include:
    • Myringotomy to equalize middle ear pressure with the external atmosphere and/or drain fluid from the middle ear. Some patients may require a myringotomy tube to be placed in the eardrum. This procedure is usually done under local anesthesia.
    • Balloon dilation of the Eustachian tube is another treatment method. This involves endoscopic insertion of a specially designed balloon into the Eustachian tube. When air is inflated into the balloon, it expands, dilating the Eustachian tube. This allows air or fluid in the middle ear to drain through the Eustachian tube into the nasopharynx. This procedure can be done under local anesthesia or general anesthesia.

 

How the Eustachian balloon works

  • The Eustachian balloon procedure can be performed under local anesthesia or general anesthesia
  • The doctor uses an endoscope to examine the nasal cavity to assess pathology and locate the Eustachian tube
  • The balloon device is inserted into the Eustachian tube, then air is inflated into the balloon. As the balloon expands, it dilates and opens the Eustachian tube

Avoid factors that reduce the body’s immunity, such as stress, insufficient sleep, colds, illness, or chronic nasal or sinus infections, because inflammation in the nasal cavity and/or sinuses affects the opening of the Eustachian tube located in the nasopharynx, leading to Eustachian tube dysfunction.


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